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Povidone-iodine, amphotericin B reduce postop infections in patients with Boston K-Pro
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CHICAGO — Prophylactic follow-up treatment with additional povidone-iodine and amphotericin B after Boston type 1 keratoprosthesis implantation significantly reduced the rate of postoperative infections, according to a speaker here.
“The purpose of our study was to compare the incidence of postoperative infection in those treated with just topical antibacterials vs. those treated with povidone-iodine plus or minus the amphotericin B,” Jeffrey D. Welder, MD, said at the American Academy of Ophthalmology meeting.
Jeffrey D. Welder
Welder and colleagues retrospectively reviewed 79 eyes of 78 patients who received vancomycin and a fluoroquinolone, additional povidone-iodine or additional povidone-iodone and amphotericin B. Patients were followed for 1 year.
Henoch-Schönlein purpura and trauma were the indications for Boston K-Pro that resulted most often in infection, according to Welder.
“Interestingly, the most common indication for K-Pro, corneal edema, did not have any infectious complications,” Welder said.
The povidone-iodine plus amphotericin B group yielded one culture-negative case of keratitis, compared with four cases of keratitis and eight with endophthalmitis in the vancomycin and fluoroquinolone group.
Boston K-pro loss occurred in 35% of eyes with postoperative infections, according to Welder.
“This [study] at least suggests the role of povidone-iodine and amphotericin B, and we are really excited to see future research,” he said.
Welder acknowledged that there was limited follow-up in the povidone-iodine group.
“We cannot tease out how significant just that alone would be,” he said.
Disclosure: Welder reports no relevant financial disclosures.